Provider Demographics
NPI:1134522808
Name:WRIGHT TURN LANE PC
Entity type:Organization
Organization Name:WRIGHT TURN LANE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:402-991-9060
Mailing Address - Street 1:8419 S 73RD PLZ STE 101
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-1507
Mailing Address - Country:US
Mailing Address - Phone:402-991-9060
Mailing Address - Fax:402-991-9052
Practice Address - Street 1:1219 APPLEWOOD DR STE 105
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-5763
Practice Address - Country:US
Practice Address - Phone:402-502-0602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1991OtherMEDICARE PTAN